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At least 937 records · Page 52Linked to original sources
PubMed1992

A one-year series of pediatric emergency department wheezing visits: the Hawaii EMS-C project.

During a 12-month period ending on November 30, 1988, data were collected on 2468 pediatric patients with wheezing who visited a pediatric ED. Cohort characteristics included: sex (64% male, 36% female), history of prematurity (12%), evidence of concurrent infection (82%), taking theophylline (35%), taking beta adrenergics (60%), taking cromolyn (6%), and taking corticosteroids (4%). The hospitalization rate was 10.5%. Seasonal variations, weather, air quality, and infections appeared to have significant effects on the daily variation of wheezing exacerbations. Initial oxygen saturation (OSAT) correlated with disease severity as measured by hospitalization risk and the number of bronchodilator treatments required in the ED. A suggestion for categorizing the treatment of asthma based on past history is proposed. Using this system in conjunction with pulse oximetry, wheezing severity and appropriate therapy can be more objectively determined.

Adolescent↗
PubMed1992

The Hawaii EMS-C project data: I. Reducing pediatric emergency morbidity and mortality; II. Statewide pediatric emergency registry to monitor morbidity and morality.

During a 12-month period ending on 11/30/88, data were collected on 16,010 pediatric patients who visited a pediatric emergency department (ED). These ED patients prospectively fell into one of the target areas for further study, including wheezing (15%), trauma (excluding burns; 29%), burns (1%), water-related injuries (1%), ingestions and toxic substance exposures (2%), child abuse (3%), handicapping conditions (5%), preventable incidents (33%), and ambulance arrivals (7%). Handicapped patients were more likely to require an ambulance. Younger patients, males, and patients with handicaps, wheezing, and Medicaid insurance were more likely to visit the ED on multiple occasions. Primary care physicians could be identified in 77% of the cohort. Large-scale interventions to reduce preventable pediatric morbidity and mortality have suffered from difficulties in documenting their effect in a population-based sample. A statewide pediatric emergency encounter registry is proposed.

Adolescent↗
PubMed1992

A one-year series of pediatric ED water-related injuries: the Hawaii EMS-C project.

During a 12-month period ending on November 30, 1988, data on 133 pediatric patients visiting a pediatric emergency department with water-related injuries were collected. Of these patients, 70% were male. There were 13 submersions, seven cases of head trauma, three cases of neck trauma, 88 cases of external injury, and 34 other injuries. Incidents took place at beaches (75%) in public pools (12%), in friends' pools (4%), and in home pools (4%). Eighty-six percent of the cohort knew how to swim. Swimming, playing, and surfing activity accounted for most of the injuries. Measures for prevention are described.

Adolescent↗
PubMedDate not supplied

Diversity of isolates of penicillinase-producing Neisseria gonorrhoeae (PPNG) in Honolulu, Hawaii: 1982-1991.

BACKGROUND AND OBJECTIVES: Gonococcal infections caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates have increased in geographic distribution and prevalence. It was postulated that PPNG strains would become endemic in Honolulu and that, in turn, this city would serve as a reservoir for the introduction of PPNG strains into the continental United States. GOAL OF THIS STUDY: To assess the role of Honolulu as a reservoir for PPNG strains by assessing the diversity and persistence of PPNG strains between 1982 and 1991. STUDY DESIGN: A total of 432 PPNG strains were characterized by auxotype/serovar (A/S) class and plasmid content, and their distribution during the 10-year period was studied. RESULTS: Of 432 isolates, 373 (86.4%) possessed a 4.4-Mdal beta-lactamase plasmid; 39 (9.0%) possessed a 3.2-Mdal beta-lactamase plasmid; and 20 (4.6%) possessed a 3.05-Mdal beta-lactamase plasmid. A total of 53 A/S classes were identified. Asian, African, and Toronto PPNG strains belonged to 49 (92.5%), 15 (28.3%), and 11 (20.7%) A/S classes, respectively. Though all Toronto PPNG strains possessed a 24.5-Mdal conjugative plasmid, these plasmids could not be transferred by conjugation. Although some apparent microepidemics of PPNG strains were identified, most strains were isolated sporadically. CONCLUSIONS: A large number of different strains have been associated with PPNG infections in Honolulu, but there was no evidence that any strain persisted endemically during the study period. These observations have important implications for the design and assessment of community gonorrhea control strategies.

Conjugation, Genetic↗
PubMed1990

Cardiovascular screening in Army personnel over age 40 in the State of Hawaii.

A cardiovascular screening protocol was applied prospectively to 1,900 soldiers over 40 years of age to identify individuals with latent coronary artery disease. Primary screening included a cardiovascular history, physical examination, electrocardiogram, serum cholesterol and serum glucose determinations, and calculated Framingham risk index. Seven hundred ninety-six individuals required secondary screening, consisting of stress testing and cardiac fluoroscopy. The screening process led to coronary angiography in 43 individuals; of these, 17 had obstructive coronary artery disease, ten had nonobstructive coronary artery disease, and 16 had normal coronary arteries. Application of primary screening before exercise testing increased the posttest probability of obstructive coronary artery disease to 50% in the individuals with a positive treadmill test. This is four times the expected value of 11% calculated using Bayes' theorem. The combination of a positive treadmill test and the finding of coronary artery calcification on fluoroscopy was an excellent predictor of obstructive coronary artery disease.

Adult↗
PubMedDate not supplied

Vasomotor symptoms among Japanese-American and European-American women living in Hilo, Hawaii.

OBJECTIVE: The Hilo Women's Health Survey was designed and administered to gather baseline data on women's health in Hilo, HI. This randomized, cross-sectional study allowed for a focus on ethnic differences in symptom reporting. The results presented here focus on hot flash and night sweat experience among Japanese-American and European-American women. DESIGN: Survey packets were mailed to street addresses associated with parcel numbers pulled randomly from Hilo tax maps. Of the 6,401 survey packets delivered to households, 1,824 questionnaires were completed and returned. The results reported here are based on 869 women aged 40 to 60, of whom 249 described themselves to be 100% Japanese and 203 described themselves to be 100% European-American. Logistic regression analyses were used to examine whether the relationship between ethnicity and vasomotor symptoms persisted after controlling for other variables. RESULTS: European-American participants were more likely to have ever experienced a hot flash as compared with Japanese-American participants (72% vs 53%, P<0.01). During the 2 weeks before the survey, European-American participants were more likely to have experienced hot flashes (P<0.05) and night sweats (P<0.01). In logistic regression analyses, after controlling for age, body mass index, menopause status, level of education, financial comfort, smoking habits, alcohol intake, exercise, use of hormone therapy, and soy intake, European-American women were still significantly more likely to have experienced hot flashes (odds ratio=1.858) and night sweats (odds ratio=2.672). CONCLUSIONS: The results, based on self-reporting of menopausal symptoms, indicate that Japanese-American women report fewer hot flashes and night sweats than European-American women. Japanese-American women reported a higher intake of soy, but soy intake was not associated with fewer vasomotor symptoms.

Adult↗
PubMed2004

Nutritional changes among premenopausal women undertaking a soya based dietary intervention study in Hawaii.

BACKGROUND: We conducted a 2-year nutritional intervention among premenopausal women. The goal was to incorporate two daily servings of soya into the regular diet. This report describes the dietary modifications and assesses their nutritional adequacy with regard to major nutrients. METHODS: In this analysis of 100 intervention and 106 control subjects, women completed a validated food-frequency questionnaire at baseline; throughout the study, they participated in at least three unannounced 24-h recalls. RESULTS: At randomization, both groups were similar in age and body weight, reported low soya intake, and did not differ by intake of major nutrients and foods. According to the 24-h recalls, women in the intervention group consumed nearly two servings of soya per day, while the control women remained at 0.2 servings. In comparison with the control group, the intervention group consumed fewer dairy products, primarily milk, but also less meat, nuts and seeds. As a result of the dietary modification, the intervention women consumed less-saturated fat and cholesterol and more protein, dietary fibre, calcium and vitamins than the control group. CONCLUSION: These results suggest that women in the intervention group improved the overall quality of their diet by adding two servings of soya per day.

Adult↗
PubMed1989

Vibrio vulnificus infection in Hawaii.

A life-threatening Vibrio vulnificus infection occurred in a 52-year-old Korean woman with hepatic cirrhosis. Four days after ingesting raw crab, the patient presented to the hospital with nausea, vomiting, fever, hypotension, and hemorrhagic blistering of the left foot. Vibrio vulnificus was recovered from both her blood and a foot wound.

Female↗
PubMed1993

Non-melanoma skin cancer and keratoacanthoma in Filipinos: an incidence report from Kauai, Hawaii.

BACKGROUND: Non-melanoma skin cancer is the most common malignancy in the white population of the United States with an estimated 700,000 new cases each year. Regrettably, data on minority racial groups are either scarce or lacking entirely. METHODS: This study was designed as a 5-year prospective incidence study of non-melanoma skin cancer and keratoacanthoma by using an island-wide survey of Kauai's Filipino residents and covers the years of 1983 to 1987. RESULTS: Seven basal cell carcinoma (incidence: 12.3/100,000), one squamous cell carcinoma (incidence: 1.8/100,000) and four keratoacanthoma (incidence: 7/100,000) patients are reported. CONCLUSIONS: To the best of our knowledge, this is the first population-based incidence report on non-melanoma skin cancer and keratoacanthoma in this population.

Aged↗
PubMed1983

A study of mental retardation in children in the Island of Hawaii.

Eighty-one probands from an initial population of 223 school-aged retarded individuals were assessed by history, clinical examination and, where appropriate, cytogenetic analysis. In 51 individuals, the retardation occurred as an isolated event within the family, whereas 30 patients had a family history of retardation. In 39 of the isolated individuals, the retardation was either related to environmental factors or associated with a major neurological abnormality. The remaining 12 patients were phenotypically normal with no cytogenetic abnormality. Of the 30 probands from 15 families with a history of retardation, 3 families had X-linked syndromes. One, with 4 proband daughters, had the mar(X) syndrome and two families were considered to have the phenotypically similar syndrome but without demonstrating the mar(X). In an additional 5 families, the distribution and clinical features of the affected individuals were compatible with nonspecific X-linked mental retardation.

Child↗
PubMed1978

A cytogenetic study of spontaneous abortions in Hawaii.

Cytogenetic results on 234 spontaneous abortions showed 109 (46.6%) to have a chromosome abnormality. The results were analysed separately for the four major ethnic groups of which the population was composed and no differences in the proportion or types of chromosome abnormalities seen. The results of this survey were found to be very similar to other major published surveys and it therefore appears, on present evidence, that neither geographic location nor racial group affects the frequency of chromosome abnormalities seen among human spontaneous abortions. The sex ratio among the chromosomally normal and abnormal abortuses and the effect of parental and gestational age were discussed.

Abortion, Spontaneous↗